Hirashima Y, Endo S, Kato R, Takaku A
Department of Neurosurgery, Toyama Medical and Pharmaceutical University, Toyama-shi, Japan.
J Neurosurg. 1996 May;84(5):826-30. doi: 10.3171/jns.1996.84.5.0826.
Recently, an important role of platelet-activating factor (PAF), an inflammation mediator, has been demonstrated in the genesis of cerebral vasospasm following subarachnoid hemorrhage (SAH). In the current study, the authors examined whether intravenous administration of the novel PAF antagonist, E5880, can prevent vasospasm following SAH in rabbits. A vasospasm model was produced in three groups of rabbits using two subarachnoid injections of autologous arterial blood, followed by intravenous administration of distilled water (control), a low dose of E5880 (0.1 mg/kg in distilled water), or a high dose of E5880 (0.5 mg/kg in distilled water). Neurological deterioration was largely prevented in the rabbits that received E5880. Basilar artery constriction was also reduced by both doses of E5880. Histological examination at autopsy predominantly showed ischemic changes in the brain. Animals in each E5880-treated group exhibited ischemic changes less frequently than those in the control group. Plasma thromboxane B2 concentrations were reduced in rabbits treated with E5880. Platelet-activating factor was immunolocalized in the intima and media of the basilar artery in the control group. The PAF immunoreactivity demonstrated in the basilar artery was decreased in the E5880 groups in a dose-dependent manner. Thus, this study provides evidence that PAF may play a role in the pathogenesis of vasospasm after SAH and that intravenous administration of E5880 is a promising approach in preventing vasospasm.
最近,炎症介质血小板活化因子(PAF)在蛛网膜下腔出血(SAH)后脑血管痉挛的发生过程中所起的重要作用已得到证实。在本研究中,作者检测了新型PAF拮抗剂E5880静脉给药是否能预防兔SAH后的血管痉挛。通过两次蛛网膜下腔注射自体动脉血,在三组兔中建立血管痉挛模型,随后分别静脉注射蒸馏水(对照组)、低剂量E5880(0.1 mg/kg溶于蒸馏水中)或高剂量E5880(0.5 mg/kg溶于蒸馏水中)。接受E5880治疗的兔神经功能恶化得到了很大程度的预防。两种剂量的E5880均能减轻基底动脉狭窄。尸检时的组织学检查主要显示脑部缺血性改变。各E5880治疗组动物出现缺血性改变的频率低于对照组。E5880治疗的兔血浆血栓素B2浓度降低。对照组中,血小板活化因子免疫定位在基底动脉的内膜和中膜。E5880组基底动脉中显示的PAF免疫反应性呈剂量依赖性降低。因此,本研究提供了证据表明PAF可能在SAH后血管痉挛的发病机制中起作用,且静脉注射E5880是预防血管痉挛的一种有前景的方法。